We never know what may bother patients about their teeth and/or smile. We can ask: “How do you feel about your smile?” Or: “Is anything bothering you in your mouth?” But we usually don’t get much in the way of answers.

Have each patient hold a hand mirror, and look at his or her smile together. Then ask a targeted question such as “How do you feel about that spot where your teeth overlap?” You may find out that these things really bother them. Now you’ve got an opening to talk about solutions.

If a patient thinks everything is great or feels uncomfortable with these questions, tell them: “You have a great smile. I ask questions to make sure that I give you the opportunity to give me feedback. I want you to know that it’s OK to talk about things that bother you.” Then move on.

During the exam, take multiple pictures with an intra-oral camera that highlight health or structural issues, or areas that could be improved cosmetically. Once images are on the screen, take the opportunity to provide consultative advice. For example:

“See that crack right there? Bacteria will collect in that spot no matter how much you brush. We should think about restoring it with a crown before it weakens or breaks the tooth or causes you pain.” 

Or: “See the inflammation around your gums? We need work on getting the tissue healthy so that you don’t risk infection or loss of one or more teeth.”

Discuss the pros and cons of available treatment options. Assure the patient that you can fix their issues as well as provide the means for them to address payment comfortably. If the patient does not accept the diagnosis, ask them to share their concerns or objections. Take the time to address them. Make sure they understand the risk of inaction and the time frame during which their condition might deteriorate. Suggest a follow-up appointment to keep a close watch on the situation.

When you adopt a genuinely caring, compassion attitude toward your patients, a forthright conversation about their dental health and cosmetic concerns can be good for patient care and good for the practice.